Skip to main content
SpringerLink
Log in

Lebensstilintegriertes funktionelles Training zur Sturzprävention

Wie und warum verändert sich das Gehverhalten?

Lifestyle-integrated functional exercise for fall prevention

How and why do walking characteristics change?

  • Themenschwerpunkt
  • Published:
Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund und Zielsetzung

Das Lifestyle-integrated-Functional-Exercise(LiFE)-Programm ermöglicht eine Steigerung der körperlichen Aktivität. Bisher ist unklar, wie sich das Aktivitätsmuster hinsichtlich der Dauer der Gehepisoden ändert.

Ziel der Arbeit

Die Veränderungen der kurzen bzw. langen Gehepisoden innerhalb von 6 Monaten sollen untersucht und die Faktoren, die mit diesen Veränderungen im Zusammenhang stehen, sollen überprüft werden.

Material und Methoden

Bizentrische randomisierte Nichtunterlegenheitsstudie mit 309 älteren Erwachsenen (78,7 ± 0,3 Jahre; 73,5 % weiblich), die das LiFE-Programm in Kleingruppen (gLiFE; n = 153) oder individualisiert (LiFE; n = 156) durchführten. Gehepisoden wurden mithilfe des Instruments activPAL 4micro erfasst; es wurde zwischen Gehepisoden mit einer jeweiligen Dauer < 10 s, < 20 s und > 60 s unterschieden. Die Veränderungen der Gehepisoden zwischen Baseline und 6 Monaten wurden überprüft; die Effektstärke (Cohens d) der Veränderungen wurde ermittelt. Einflussfaktoren der Gehepisodenveränderungen wurden mithilfe multipler Regression modelliert.

Ergebnisse

Die Gehepisoden mit den Dauern < 10 s und < 20 s wiesen in beiden Interventionsgruppen signifikante Steigerungen auf, nicht aber jene mit der Dauer > 60 s. Einfluss auf die Veränderung der Gehepisoden zwischen Baseline und Sechsmonatsmessung hatten die Gehdauer und die durchschnittliche Schrittzahl/Tag. Maße der objektiven und subjektiven Funktion lieferten einen sehr geringen, aber signifikanten Beitrag zur Varianzaufklärung der Veränderung.

Diskussion

Das LiFE-Programm entfaltet seine Wirkung vornehmlich als Verhaltensintervention. Kurze Gehepisoden bieten kumuliert ein großes Potenzial zur Steigerung der körperlichen Aktivität. Dies kann insbesondere für Personen in institutionellen Settings oder jene, die sich längeres Gehen (außerhäuslich) nicht mehr zutrauen, von gesundheitsförderlichem Nutzen sein.

Abstract

Background

The lifestyle-integrated functional exercise (LiFE) program has been shown to increase physical activity. It remains unclear, however, how these changes translate into long vs. short walking episodes.

Objective

The aim of this work was to investigate changes in short vs. long walking episodes between baseline and 6‑month follow-up and to determine which factors are associated with these changes.

Material and methods

This was a two-arm randomized noninferiority study with 309 older adults (mean age 78.7 ± 0.3 years; 73.5% female) at risk of falling who exercised either in a group (gLiFE; n = 153) or individually (LiFE; n = 156). Walking episodes were measured using activPAL 4micro sensors: a distinction was made between walking episodes < 10s, < 20s, and > 60 s. Changes in walking episodes between baseline and 6‑month follow-up were analyzed, including calculation of effect sizes (Cohen’s d). Determinants of changes in the walking episodes were analyzed using multiple regression.

Results

The walking episodes < 10s and < 20 s showed a significant increase in both intervention groups but not for > 60 s. The overall daily walking duration and average steps per day had an influence on changes in the walking episodes between baseline and 6 months. Parameters of objective and subjective function explained a very small but significant amount of the variance.

Conclusion

The LiFE program seems to work on a behavioral rather than on a functional level. By accumulating short walking episodes, large gains in physical activity can potentially be achieved. This can be of health-promoting benefit especially for persons living in institutional settings or for those who are cautious or even anxious to undertake longer walking episodes (e.g., outdoors).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Berg WP, Alessio HM, Mills EM et al (1997) Circumstances and consequences of falls in independent community-dwelling older adults. Age Ageing 26:261–268

    Article  CAS  PubMed  Google Scholar 

  2. Clemson L, Fiatarone Singh MA, Bundy A et al (2012) Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ 345:e4547

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum

    Google Scholar 

  4. Coppin AK, Shumway-Cook A, Saczynski JS et al (2006) Association of executive function and performance of dual-task physical tests among older adults: analyses from the InChianti study. Age Ageing 35:619–624

    Article  PubMed  Google Scholar 

  5. Duvivier BM, Schaper NC, Hesselink MK et al (2017) Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes. Diabetologia 60:490–498

    Article  CAS  PubMed  Google Scholar 

  6. Gennuso KP, Gangnon RE, Matthews CE et al (2013) Sedentary behavior, physical activity, and markers of health in older adults. Med Sci Sports Exerc 45:1493–1500

    Article  PubMed  PubMed Central  Google Scholar 

  7. Haley SM, Jette AM, Coster WJ et al (2002) Late life function and disability instrument: II. development and evaluation of the function component. J Gerontol A Biol Sci Med Sci 57:M217–222

    Article  PubMed  Google Scholar 

  8. Hartman YAW, Tillmans LCM, Benschop DL et al (2021) Long-term and acute benefits of reduced sitting on vascular flow and function. Med Sci Sports Exerc 53:341–350

    Article  PubMed  Google Scholar 

  9. Hauer KA, Kempen GI, Schwenk M et al (2011) Validity and sensitivity to change of the falls efficacy scales international to assess fear of falling in older adults with and without cognitive impairment. Gerontology 57:462–472

    Article  PubMed  Google Scholar 

  10. Jansen C‑P, Gottschalk S, Nerz C et al (2023) Comparison of falls and cost-effectiveness of the group versus individually delivered Lifestyle-integrated Functional Exercise (LiFE) program: final results from the LiFE-is-LiFE non-inferiority trial. Age Ageing 52:afac331

    Article  PubMed  Google Scholar 

  11. Jansen CP, Nerz C, Kramer F et al (2018) Comparison of a group-delivered and individually delivered lifestyle-integrated functional exercise (LiFE) program in older persons: a randomized noninferiority trial. BMC Geriatr 18:267

    Article  PubMed  PubMed Central  Google Scholar 

  12. Jansen CP, Nerz C, Labudek S et al (2021) Lifestyle-integrated functional exercise to prevent falls and promote physical activity: results from the LiFE-is-LiFE randomized non-inferiority trial. Int J Behav Nutr Phys Act 18:115

    Article  PubMed  PubMed Central  Google Scholar 

  13. Jefferis BJ, Merom D, Sartini C et al (2015) Physical activity and falls in older men: the critical role of mobility limitations. Med Sci Sports Exerc 47:2119–2128

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jones CJ, Rikli RE, Beam WC (1999) A 30‑s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport 70:113–119

    Article  CAS  PubMed  Google Scholar 

  15. Kampe K, Pfeiffer K, Lindemann U et al (2021) Change of physical activity parameters of hip and pelvic fracture patients during inpatient rehabilitation and after discharge: analysis of global and in-depth parameters. Eur Rev Aging Phys Act 18:9

    Article  PubMed  PubMed Central  Google Scholar 

  16. Keadle SK, Mckinnon R, Graubard BI et al (2016) Prevalence and trends in physical activity among older adults in the United States: a comparison across three national surveys. Prev Med 89:37–43

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kramer F, Labudek S, Jansen CP et al (2020) Development of a conceptual framework for a group-based format of the Lifestyle-integrated Functional Exercise (gLiFE) programme and its initial feasibility testing. Pilot Feasibility Stud 6:6

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lawton BA, Rose SB, Elley CR et al (2008) Exercise on prescription for women aged 40–74 recruited through primary care: two year randomised controlled trial. BMJ 337:a2509

    Article  PubMed  PubMed Central  Google Scholar 

  19. Meyer BM, Tulipani LJ, Gurchiek RD et al (2022) Open-source dataset reveals relationship between walking bout duration and fall risk classification performance in persons with multiple sclerosis. Plos Digit Health 1:e120

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nasreddine ZS, Phillips NA, Bedirian V et al (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699

    Article  PubMed  Google Scholar 

  21. Nerz C, Kramer-Gmeiner F, Jansen CP et al (2022) Group-based and individually delivered LiFE: content evaluation and predictors of training response—A dose-response analysis. Clin Interv Aging 17:637–652

    Article  PubMed  PubMed Central  Google Scholar 

  22. Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148

    Article  CAS  PubMed  Google Scholar 

  23. Powell LE, Myers AM (1995) The activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci 50a:M28–M34

    Article  CAS  PubMed  Google Scholar 

  24. Rabin R, Charro FD (2001) EQ-SD: a measure of health status from the EuroQol Group. Ann Med 33:337–343

    Article  CAS  PubMed  Google Scholar 

  25. Radloff LS (1977) The CES‑D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  26. Reicherzer L, Kramer-Gmeiner F, Labudek S et al (2021) Group or individual lifestyle-integrated functional exercise (LiFE)? A qualitative analysis of acceptability. BMC Geriatr 21:93

    Article  PubMed  PubMed Central  Google Scholar 

  27. Schwenk M, Bergquist R, Boulton E et al (2019) The adapted lifestyle-integrated functional exercise program for preventing functional decline in young seniors: development and initial evaluation. Gerontology 65:362–374

    Article  PubMed  Google Scholar 

  28. Shah VV, Mcnames J, Harker G et al (2020) Effect of bout length on gait measures in people with and without parkinson’s disease during daily life. Sensors 20:5769. https://doi.org/10.3390/s20205769

    Article  PubMed  PubMed Central  Google Scholar 

  29. Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319:1701–1707

    Article  CAS  PubMed  Google Scholar 

  30. Yardley L, Beyer N, Hauer K et al (2005) Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing 34:614–619

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Geriatrische Rehabilitation, Robert-Bosch-Krankenhaus, Auerbachstraße 110, 70376, Stuttgart, Deutschland

    Christoph Endress, Clemens Becker & Carl-Philipp Jansen

  2. Human Performance Research Centre, Abteilung für Sportwissenschaft, Universität Konstanz, Konstanz, Deutschland

    Michael Schwenk

  3. Geriatrisches Zentrum, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Christoph Endress, Christian Werner & Carl-Philipp Jansen

  4. Unit Digitale Geriatrie, Geriatrisches Zentrum, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    Clemens Becker

Authors
  1. Christoph Endress
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Schwenk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Werner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Clemens Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carl-Philipp Jansen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Carl-Philipp Jansen.

Ethics declarations

Interessenkonflikt

C. Endress, M. Schwenk, C. Werner, C. Becker und C.-P. Jansen geben an, dass kein Interessenkonflikt besteht.

Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Endress, C., Schwenk, M., Werner, C. et al. Lebensstilintegriertes funktionelles Training zur Sturzprävention. Z Gerontol Geriat 56, 464–469 (2023). https://doi.org/10.1007/s00391-023-02230-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00391-023-02230-y

Schlüsselwörter

Keywords

Search

Navigation